|
Ecg 12 lead tracing only
|
$274.80 |
$274.80 |
$274.80 |
$222.30
|
|
Ecg external < 48 hours recording
|
$643.80 |
$643.80 |
$643.80 |
$461.76
|
|
Ecg external > 48 hours up to 7 days recording
|
$336.00 |
$336.00 |
$336.00 |
$180.00
|
|
Ecg external >7 days up to 15 days recording
|
$672.60 |
$672.60 |
$672.60 |
$213.20
|
|
Echocardiogram (Heart Ultrasound)
|
$3,320.40 |
$3,320.40 |
$3,320.40 |
$2,021.12
|
|
Echocardiography doppler color flow mapping
|
$598.20 |
$598.20 |
$598.20 |
$450.40
|
|
Echocardiography transthoracic 2d followup/limited
|
$3,320.40 |
$3,320.40 |
$3,320.40 |
$720.60
|
|
Echocardiograpy doppler follow up/limited study
|
$356.40 |
$356.40 |
$356.40 |
$348.80
|
|
Echo transthoracic
|
$2,461.80 |
$2,461.80 |
$2,461.80 |
$1,361.75
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$997.40
|
|
Electrical stimulation/unattended 97014
|
$102.00 |
$102.00 |
$102.00 |
$79.20
|
|
Electrolyte panel
|
$39.00 |
$39.00 |
$39.00 |
$68.56
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$75.04 |
$75.04 |
$75.04 |
$43.20
|
|
Entamoeba histolytica ag eia - sendout
|
$153.60 |
$153.60 |
$153.60 |
$68.90
|
|
Epstein barr early antigen antibody
|
$127.80 |
$127.80 |
$127.80 |
$85.20
|
|
Epstein barr nuclear antigen antibody
|
$94.80 |
$94.80 |
$94.80 |
$88.80
|
|
Epstein barr viral capsid antigen antibody igm
|
$179.40 |
$179.40 |
$179.40 |
$112.50
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$364.08 |
$364.08 |
$364.08 |
$138.28
|
|
ER Visit (level 1, minor)
|
$155.40 |
$155.40 |
$155.40 |
$270.00
|
|
ER Visit (level 2)
|
$481.20 |
$481.20 |
$481.20 |
$469.39
|
|
ER Visit (level 3)
|
$776.40 |
$776.40 |
$776.40 |
$821.52
|
|
ER Visit (level 4)
|
$1,304.40 |
$1,304.40 |
$1,304.40 |
$1,320.00
|
|
ER Visit (level 5, high severity)
|
$2,173.80 |
$2,173.80 |
$2,173.80 |
$1,900.20
|
|
Established Patient Office Visit (level 1)
|
$204.00 |
$204.00 |
$204.00 |
$118.20
|
|
Established Patient Office Visit (level 2)
|
$198.60 |
$198.60 |
$198.60 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$210.00 |
$210.00 |
$210.00 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$240.00 |
$240.00 |
$240.00 |
$213.21
|
|
Established Patient Office Visit (level 5)
|
$270.00 |
$270.00 |
$270.00 |
$270.09
|
|
Estradiol total
|
$255.00 |
$255.00 |
$255.00 |
$142.20
|
|
Estrogens total-sendout
|
$66.00 |
$66.00 |
$66.00 |
$111.00
|
|
Evaluation of speech fluency 92521
|
$250.80 |
$250.80 |
$250.80 |
$347.75
|
|
Evaluation psychiatric diagnostic
|
$426.00 |
$426.00 |
$426.00 |
$325.65
|
|
Event monitor
|
$634.80 |
$634.80 |
$634.80 |
$228.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$113.40 |
$113.40 |
$113.40 |
$102.50
|
|
Facial bones <3
|
$281.40 |
$281.40 |
$281.40 |
$216.45
|
|
Factor ix
|
$127.80 |
$127.80 |
$127.80 |
$139.75
|
|
Factor viii
|
$187.80 |
$187.80 |
$187.80 |
$152.50
|
|
Family therapy without pt 50min 90846
|
$213.00 |
$213.00 |
$213.00 |
$230.40
|
|
Family therapy with patient 50 min 90847
|
$246.00 |
$246.00 |
$246.00 |
$224.80
|
|
Fat/lipids feces qualitative
|
$71.40 |
$71.40 |
$71.40 |
$43.66
|
|
#fecal-sodium
|
$32.40 |
$32.40 |
$32.40 |
$40.30
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$43.23 |
$43.23 |
$43.23 |
$48.88
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$2,131.58 |
$2,131.58 |
$2,131.58 |
$2,131.58
|
|
Ferritin
|
$94.20 |
$94.20 |
$94.20 |
$86.45
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$1,392.29 |
$1,392.29 |
$1,392.29 |
$2,289.60
|
|
Fibrin degradation d dimer quantitative
|
$119.40 |
$119.40 |
$119.40 |
$87.60
|
|
Fibrinogen activity
|
$146.40 |
$146.40 |
$146.40 |
$61.80
|
|
Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr
|
$1,223.60 |
$1,223.60 |
$1,223.60 |
$1,223.60
|
|
Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback
|
$63.52 |
$63.52 |
$63.52 |
$48.56
|
|
Fluorescent antibody titer dna
|
$226.20 |
$226.20 |
$226.20 |
$123.65
|
|
Fluoroscopy up to 1 hour
|
$635.40 |
$635.40 |
$635.40 |
$474.50
|
|
Folic acid
|
$194.40 |
$194.40 |
$194.40 |
$85.50
|
|
Fondaparinux sodium
|
$126.88 |
$126.88 |
$126.88 |
$121.83
|
|
Foot X-ray
|
$562.80 |
$562.80 |
$562.80 |
$339.50
|
|
Fructosamine glycated protein
|
$64.20 |
$64.20 |
$64.20 |
$69.55
|
|
Gadobutrol 1 mmol/ml intravenous solution (wrapper)
|
$0.59 |
$0.59 |
$0.59 |
$2.04
|
|
Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution
|
$0.18 |
$0.18 |
$0.18 |
$13.18
|
|
Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution
|
$25.56 |
$25.56 |
$25.56 |
$90.60
|
|
Gammaglobulin iga
|
$124.80 |
$124.80 |
$124.80 |
$78.60
|
|
Gammaglobulin ige
|
$66.60 |
$66.60 |
$66.60 |
$87.10
|
|
Gamma glutamyltransferase
|
$73.20 |
$73.20 |
$73.20 |
$54.60
|
|
Gardner vag dna quant
|
$119.40 |
$119.40 |
$119.40 |
$104.80
|
|
General health panel
|
$318.60 |
$318.60 |
$318.60 |
$270.40
|
|
Gentamicin 10 mg/ml liquid compound - enteral use only
|
$38.83 |
$38.83 |
$38.83 |
$30.76
|
|
Gentamicin peak therapeutic drug level
|
$187.20 |
$187.20 |
$187.20 |
$114.00
|
|
Ghs antibodies (torch) igm
|
$113.40 |
$113.40 |
$113.40 |
$82.50
|
|
Ghs bladder cath - complex-foley
|
$289.80 |
$289.80 |
$289.80 |
$333.18
|
|
Ghs corneal fb without slit lamp bilat
|
$265.20 |
$265.20 |
$265.20 |
$422.25
|
|
Ghs histoplasma antigen
|
$336.00 |
$336.00 |
$336.00 |
$157.30
|
|
Ghs HIV antibody
|
$125.40 |
$125.40 |
$125.40 |
$90.14
|
|
Ghs moderate sedation < 5 yr, 30 min
|
$674.40 |
$674.40 |
$674.40 |
$240.00
|
|
Ghs moderate sedation ea addtl 15 min
|
$102.60 |
$102.60 |
$102.60 |
$125.34
|
|
Ghs myocardial strain img spckl track
|
$545.40 |
$545.40 |
$545.40 |
$503.85
|
|
Ghs o2 saturation
|
$91.80 |
$91.80 |
$91.80 |
$55.90
|
|
Ghs ot dds rom
|
$51.60 |
$51.60 |
$51.60 |
$53.01
|
|
Ghs pacing - transcutaneous
|
$940.20 |
$940.20 |
$940.20 |
$872.95
|
|
Ghs path - pap (papanicolau) smear - vagina
|
$90.00 |
$90.00 |
$90.00 |
$82.80
|
|
Ghs plt ct-manual
|
$21.60 |
$21.60 |
$21.60 |
$40.80
|
|
Ghs ppd (tb intradermal)
|
$50.40 |
$50.40 |
$50.40 |
$39.77
|
|
Ghs protein, misc fluid
|
$27.60 |
$27.60 |
$27.60 |
$24.60
|
|
Ghs pr without cont pulse ox
|
$286.80 |
$286.80 |
$286.80 |
$165.60
|
|
Ghs reticulocyte count
|
$18.60 |
$18.60 |
$18.60 |
$33.57
|
|
Ghs rsv eia (respir synctial vrs)
|
$121.80 |
$121.80 |
$121.80 |
$117.60
|
|
Ghs sedimentation rate
|
$28.20 |
$28.20 |
$28.20 |
$36.57
|
|
Ghs sensitivity (per antimicro)
|
$56.40 |
$56.40 |
$56.40 |
$55.12
|
|
Ghs simple repair 5.1 - 7.5 cm - 12014
|
$385.20 |
$385.20 |
$385.20 |
$439.40
|
|
Ghs urine, porphyrins quant
|
$72.60 |
$72.60 |
$72.60 |
$85.15
|
|
Gi inhouse confirmation
|
$127.80 |
$127.80 |
$127.80 |
$79.50
|
|
Glucagon 1 mg solution for injection
|
$351.53 |
$351.53 |
$351.53 |
$351.53
|
|
Glucose 1 hr post dose
|
$73.20 |
$73.20 |
$73.20 |
$40.00
|
|
Glucose blood by monitoring device cleared by fda for home use
|
$13.20 |
$13.20 |
$13.20 |
$20.00
|
|
Glucose blood quantitative
|
$44.40 |
$44.40 |
$44.40 |
$40.80
|
|
Glucose body fluid
|
$57.00 |
$57.00 |
$57.00 |
$47.70
|
|
Glucose tolerance test (gtt) 3 specimens
|
$67.20 |
$67.20 |
$67.20 |
$92.75
|
|
Glucose tolerance test (gtt) >3 specimens each additional
|
$21.60 |
$21.60 |
$21.60 |
$33.15
|
|
Glycopyrrolate 0.2 mg/ml injection solution
|
$120.40 |
$120.40 |
$120.40 |
$11.60
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$133.80 |
$133.80 |
$133.80 |
$115.05
|
|
Gonadotropin luteinizing hormone (lh)
|
$141.60 |
$141.60 |
$141.60 |
$117.65
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$51.04 |
$51.04 |
$51.04 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$38.87 |
$38.87 |
$38.87 |
$11.25
|
